Our Summary

In this study, the researchers looked at the effectiveness of a specific surgical procedure for patients suffering from a painful condition where nerve roots or the spinal cord are compressed, causing pain or numbness radiating in the arms (radiculomyelopathy). This procedure included three main steps: microdiscectomy (removal of a small part of the spinal disc), cage fixation (placement of a tiny cage to stabilize the spine), and a right keyhole transuncal foraminotomy (creating a small hole to relieve pressure on nerve roots in the spine).

The study was based on a technique reported in 1976, which was designed for right-handed surgeons. The researchers reviewed their own patients who were treated with this procedure for right-sided nerve root compression causing pain or numbness.

Since 2011, 23 patients were treated with this method. All patients experienced significant improvement or complete disappearance of their symptoms without any complications after the surgery. The average pain score was reduced from 7.6 to 1.1 in a month after surgery, and no patients had a recurrence of their symptoms for an average of 38.3 months follow-up.

The researchers concluded that this procedure is an effective and safe treatment option for right-sided nerve root and spinal canal compression if the surgeon is familiar with the anatomy.

FAQs

  1. What is microdiscectomy and how is it used in the treatment of radiculomyelopathy?
  2. What were the results of the study on the effectiveness of the surgical procedure involving microdiscectomy, cage fixation, and a right keyhole transuncal foraminotomy?
  3. How many patients have been treated with this method since 2011 and what were their outcomes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about microdiscectomy is to make sure to follow post-operative care instructions carefully, including proper wound care, medication management, and physical therapy. It is also important to listen to your body and not push yourself too hard during the recovery process. It is common to experience some discomfort or stiffness after surgery, but if you notice any new or worsening symptoms, be sure to contact your doctor immediately.

Suitable For

Typically, patients who are recommended microdiscectomy are those suffering from conditions such as herniated discs, sciatica, spinal stenosis, or nerve root compression. These patients may experience symptoms such as severe back pain, leg pain, numbness, weakness, or tingling in the affected area. The decision to undergo microdiscectomy is usually made after conservative treatments such as physical therapy, medication, or injections have not provided relief. It is important for patients to consult with a healthcare provider to determine if microdiscectomy is the right treatment option for their specific condition.

Timeline

Before the microdiscectomy:

  • Patient experiences pain or numbness radiating in the arms
  • Patient undergoes diagnostic tests such as MRI to confirm nerve root compression
  • Surgeon recommends microdiscectomy as a treatment option
  • Patient undergoes pre-operative evaluations and consultations
  • Surgery is scheduled and patient prepares for the procedure

After the microdiscectomy:

  • Patient undergoes the microdiscectomy, cage fixation, and transuncal foraminotomy procedure
  • Patient wakes up from surgery and is monitored in the recovery room
  • Patient is given pain medication and instructions for post-operative care
  • Patient is discharged from the hospital after a short stay
  • Patient may experience some pain and discomfort initially but should see improvement in symptoms over time
  • Patient follows up with the surgeon for post-operative evaluations and rehabilitation
  • Patient experiences significant improvement or complete disappearance of symptoms without complications
  • Patient continues to see improvement in pain scores and function over the following months
  • Patient has no recurrence of symptoms during follow-up appointments

Overall, the patient goes through a process of evaluation, surgery, recovery, and follow-up care to successfully treat their nerve root compression through microdiscectomy.

What to Ask Your Doctor

  1. What is the success rate of microdiscectomy for my specific condition?
  2. What are the potential risks and complications associated with microdiscectomy?
  3. What is the recovery process like after microdiscectomy surgery?
  4. Are there any alternative treatment options to consider before undergoing microdiscectomy?
  5. How experienced are you in performing microdiscectomy surgeries?
  6. Will I need physical therapy or rehabilitation after the surgery?
  7. How long will it take for me to see results from the surgery?
  8. What can I do to help ensure a successful outcome from the surgery?
  9. Are there any restrictions or limitations I should be aware of after the surgery?
  10. How long will I need to be off work or activities following the surgery?

Reference

Authors: Okazaki T, Nakagawa H, Mure H, Yagi K, Hayase H, Takagi Y, Saito K. Journal: Neurol Med Chir (Tokyo). 2018 Nov 15;58(11):468-476. doi: 10.2176/nmc.oa.2018-0077. Epub 2018 Oct 6. PMID: 30298831